尿流动力学分析在胸腰段脊髓损伤所致神经源性膀胱功能评估中的应用及意义  

The application and significance of urine flow dynamic analysis in function evaluation for neurogenic bladder caused by thoracic lumbar spinal cord injury

作　　者：沈峰[1] 

机构地区：[1]同济大学附属上海市养志康复医院(上海市阳光康复中心)脊髓损伤康复病区,上海201619

出　　处：《国际泌尿系统杂志》2015年第3期384-386,共3页International Journal of Urology and Nephrology

摘　　要：目的探讨尿流动力学分析在胸腰段脊髓损伤所致神经源性膀胱功能评估中的应用及意义。方法选取80例胸腰段脊髓损伤伴排尿障碍患者为研究对象，分析患者膀胱顺应性、逼尿肌反射、逼尿肌外括约肌协调等指标。结果80例中64例（80％）出现逼尿肌反射亢进，其中伴尿道外括约肌协调22例，失调42例；16例出现逼尿肌无反射（20％），其中伴尿道外括约肌协调4例，失调4例，去神经化8例。80例中16例（20％）表现为膀胱顺应性增加，64例（80％）表现为膀胱顺应性下降。结论胸腰段脊髓损伤患者大多表现为逼尿肌反射亢进，仍有部分表现为逼尿肌无反射。并根据尿道括约肌功能进一步分为数种亚型。尿动力学检查在胸腰段脊髓损伤中明确了神经源性膀胱的类型，为治疗及预后判断提供价值。Objectives To evaluate the application and significance of urine flow dynamic analysis in func- tion evaluation for neurogenic bladder caused by thoracic lumbar spinal cord injury. Methods Selected 80 cases of thoracic lumbar spinal cord injury with urination disorders as the research object. Analyzed the index of bladder compliance, detrusor reflex and detrusor - external sphincter dyssynergia. Results In the total 80 cases, 64 cases （80%） of detrusor hyperreflexia,included 22 cases with urethral sphincter coordinate,42 cases with imbalance. 16 cases （20%） of detrusor areflexia,included 4 cases with urethral sphincter coordinate ,4 cases with imbalance,8 cases with denervation. In total 80 cases,16 cases（20% ） of bladder compliance increased,64 cases （80%） with bladder compliance decreased. Conclusions Thoracic lumbar spinal cord injury patients usually show the detrusor hy- perreflexia, and there are still a part of detrusor areflexia. According to the urethral sphincter function, neurogenie bladder is further divided into several subtypes. Urine flow dynamic analysis in thoracic lumbar spinal cord injury has been clear about the type of neurogenic bladder,provide value for treatment and prognosis judgement.

关 键 词：膀胱 神经原性 脊柱损伤 尿动力学 

分 类 号：R694[医药卫生—泌尿科学]